International Journal of Mental Health Nursing最新文献

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Knowledge, Attitudes and Practices of Mental Health Professionals Regarding Trauma-Informed Care 心理健康专业人员关于创伤知情护理的知识、态度和实践
IF 3.6 2区 医学
International Journal of Mental Health Nursing Pub Date : 2025-05-23 DOI: 10.1111/inm.70069
Figen İnci, Fahriye Oflaz, Ayşe Büyükbayram Arslan, Buket Şimşek Arslan, Nurhayat Kılıç Bayageldi
{"title":"Knowledge, Attitudes and Practices of Mental Health Professionals Regarding Trauma-Informed Care","authors":"Figen İnci,&nbsp;Fahriye Oflaz,&nbsp;Ayşe Büyükbayram Arslan,&nbsp;Buket Şimşek Arslan,&nbsp;Nurhayat Kılıç Bayageldi","doi":"10.1111/inm.70069","DOIUrl":"https://doi.org/10.1111/inm.70069","url":null,"abstract":"<div>\u0000 \u0000 <p>Trauma-informed care is a model aimed at developing more conscious, sensitive and holistic approaches for trauma survivors. This study examined the knowledge, skills and attitudes of mental health professionals, including nurses, physicians and psychologists, regarding trauma-informed care. A cross-sectional design and a convenience sampling method were used, with a sample consisting of 197 healthcare professionals. Data were collected through an online survey using the Trauma-Informed Care Scale and the Trauma Intervention Skills Scale. Analyses were conducted using Spearman correlation analysis, Mann–Whitney U and Kruskal–Wallis tests. Results revealed that more than half of the participants (55.3%) were unaware of the concept of trauma-informed care, and only 14.2% felt competent in presenting this care model. Gender, age and education level did not significantly affect Trauma-informed care scores (<i>p</i> &gt; 0.05); however, participants who had received education on trauma-informed care during their years of education scored higher (<i>p</i> &lt; 0.05). In the grouping of participants according to their professions, practitioners/family physicians had a statistically significantly lower score on the Trauma-Informed Care Scale than nurses, psychologists and social workers in the total score, and psychological counsellors scored lower than nurses. The findings indicate that while mental health professionals possess knowledge about trauma but many lack an understanding of trauma-informed care, and few feel competent in applying trauma-informed care. To enhance the capacity for trauma-informed care, integrating it into undergraduate curricula and reflecting it in healthcare settings is essential.</p>\u0000 </div>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychiatric Emergency or General Emergency: Evolution or Involution? A Qualitative Study With Mental Health and Emergency Professionals 精神急症还是普通急症:进化还是退化?心理健康与急救专业人员的质性研究
IF 3.6 2区 医学
International Journal of Mental Health Nursing Pub Date : 2025-05-19 DOI: 10.1111/inm.70063
Camuccio Carlo Alberto, Zara Silvia
{"title":"Psychiatric Emergency or General Emergency: Evolution or Involution? A Qualitative Study With Mental Health and Emergency Professionals","authors":"Camuccio Carlo Alberto,&nbsp;Zara Silvia","doi":"10.1111/inm.70063","DOIUrl":"https://doi.org/10.1111/inm.70063","url":null,"abstract":"<p>The treatment of individuals with psychiatric disorders who visit the Emergency Department (ED) remains a significant issue within healthcare organisations. Over the past decades, various organisational solutions have been proposed, ranging from dedicated Emergency Departments to liaison mechanisms involving mental health nurses within EDs or direct access to acute units. On one hand, there are clinical and organisational needs pushing towards the creation of dedicated pathways; on the other hand, there are concerns that such solutions may be counterproductive and dangerous in terms of health and social inclusion. The aim of this study is to assess the opinions of Mental Health and Emergency professionals on the advantages and disadvantages of clinical and organisational pathways dedicated to patients with psychiatric disorders who visit the general ED. The study was conducted using a qualitative research approach: semi-structured interviews were carried out through purposeful sampling composed of two cohorts: Emergency and Mental Health professionals. The data were analysed using content analysis with the software Atlas.ti. Forty-five interviews were collected, and six main themes/families were identified. A certain distance in opinions between the two cohorts emerged, especially regarding the adoption of dedicated pathways. In both cohorts, but particularly in the mental health cohort, there is a fear of stigmatisation and violation of patients' rights in dedicated pathways. Both groups believe that there is a need for more specific training and greater multidisciplinarity. This study adheres to the COREQ checklist for qualitative studies.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Are EDs the Only Option? Hospital-Based Alternatives to the Emergency Department for Mental Health Crises: A Scoping Review 急诊是唯一的选择吗?以医院为基础的精神健康危机急诊室的替代方案:范围审查
IF 3.6 2区 医学
International Journal of Mental Health Nursing Pub Date : 2025-05-19 DOI: 10.1111/inm.70060
Carly Hudson, Candice Bowman, Marcus Randall
{"title":"Are EDs the Only Option? Hospital-Based Alternatives to the Emergency Department for Mental Health Crises: A Scoping Review","authors":"Carly Hudson,&nbsp;Candice Bowman,&nbsp;Marcus Randall","doi":"10.1111/inm.70060","DOIUrl":"https://doi.org/10.1111/inm.70060","url":null,"abstract":"<p>Mental health continues to have a significant negative impact on global health. Hospital emergency departments (EDs) serve as a first entry point for individuals in crisis, with the number of presentations to EDs for mental health continuing to increase. However, EDs remain problematic environments for patients receiving emergency psychiatric care, due to the lack of suitable space, resources and specialised staff training. The World Health Organization has acknowledged the need to restructure mental health services to prioritise accessibility and person-centred care. To address this need, a number of alternative crisis care services have been established, which provide short-term emergency psychiatric care. This scoping review aims to provide an overview of the types of crisis services available within or adjacent to a hospital service. A systematic search of CINAHL, Medline, SocIndex and PsycINFO was conducted, returning 1213 results. Following title and abstract, and full text screening, 17 sources were included in the final review. Alternative crisis care services situated within or near existing hospital sites were broadly grouped into four categories: psychiatric emergency services, crisis stabilisation or observation units, specialised services for specific populations and non-clinical crisis services. Of the included articles, 13 reported some form of service evaluation, examining a range of patient-, staff- and service-factors. Alternative crisis care services to the ED play a crucial role in providing accessible, localised support for individuals experiencing mental health crisis, potentially reducing the reliance on hospital-based services. However, to date, there is a lack of consistency in service descriptions, and comprehensiveness of service evaluations. Standardised and more thorough reporting of crisis care services is required to better understand what services are available, and the impact they are having on mental health crisis care.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144091651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of Priority Outcome Domains for Community Mental Health Research via Consensus Among Multiple Stakeholders: Online Delphi Study in Japan 通过多方利益相关者的共识发展社区心理健康研究的优先结果领域:日本的在线德尔菲研究
IF 3.6 2区 医学
International Journal of Mental Health Nursing Pub Date : 2025-05-14 DOI: 10.1111/inm.70049
Takuma Shiozawa, Sosei Yamaguchi, Momoka Igarashi, Makoto Ogawa, Makiko Abe, Naonori Yasuma, Takayuki Kawaguchi, Chiyo Fujii
{"title":"Development of Priority Outcome Domains for Community Mental Health Research via Consensus Among Multiple Stakeholders: Online Delphi Study in Japan","authors":"Takuma Shiozawa,&nbsp;Sosei Yamaguchi,&nbsp;Momoka Igarashi,&nbsp;Makoto Ogawa,&nbsp;Makiko Abe,&nbsp;Naonori Yasuma,&nbsp;Takayuki Kawaguchi,&nbsp;Chiyo Fujii","doi":"10.1111/inm.70049","DOIUrl":"https://doi.org/10.1111/inm.70049","url":null,"abstract":"<p>Several core outcome sets (COS) have been developed in the field of mental health; however, the specific outcome domains that should be prioritised in community mental health research remain unclear. This study aimed to identify the key outcome domains for community mental health research in Japan, as determined by multiple stakeholders. First, a comprehensive list of outcome domains was compiled by scoping reviews, focus group interviews, and web-based questionnaire surveys. This was followed by two rounds of preliminary surveys with multiple stakeholders. Finally, three rounds of a web-based Delphi survey were conducted to determine the most important outcome domains of community mental health research in Japan. A total of 96 outcome domains were evaluated by 297 participants, with a response rate of 93.6%. This study identified 24 outcome domains that are essential for community mental health research in Japan. These 24 domains, which reached a consensus, included aspects related to comprehensive symptom assessment and personal recovery. Given that community care serves patients with diverse illnesses, identifying outcome domains that are broadly applicable across different community care settings rather than being limited to specific conditions is critical for future research. The study also highlights differences in perspectives among stakeholders regarding the importance of various outcomes. Despite these differences, several outcome domains have been recognised as being significantly important in the overall consensus.</p><p><b>Trial Registration:</b> University Hospital Medical Information Network (UMIN) Clinical Trials Registry: UMIN000044680.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Working With Patients Who Self-Injure: An Open Label Study of an Educational Intervention to Upskill Emergency Nurses on Non-Suicidal Self-Injury 与自残患者一起工作:提高急诊护士非自杀性自残技能的开放标签研究
IF 3.6 2区 医学
International Journal of Mental Health Nursing Pub Date : 2025-05-14 DOI: 10.1111/inm.70064
Penelope Hasking, Amanda Aiyana, Jonathon Burcham, Samantha Carey, Joanne M. Dickson, Daniel Fatovich, Logan Hopkins, Eme John, Shirley McGough, Chloe McLean, Irene Ngune, Alex Wheeler
{"title":"Working With Patients Who Self-Injure: An Open Label Study of an Educational Intervention to Upskill Emergency Nurses on Non-Suicidal Self-Injury","authors":"Penelope Hasking,&nbsp;Amanda Aiyana,&nbsp;Jonathon Burcham,&nbsp;Samantha Carey,&nbsp;Joanne M. Dickson,&nbsp;Daniel Fatovich,&nbsp;Logan Hopkins,&nbsp;Eme John,&nbsp;Shirley McGough,&nbsp;Chloe McLean,&nbsp;Irene Ngune,&nbsp;Alex Wheeler","doi":"10.1111/inm.70064","DOIUrl":"https://doi.org/10.1111/inm.70064","url":null,"abstract":"<p>Non-suicidal self-injury (NSSI), deliberate damage to body tissue with no intent to die, is not engaged with suicidal intent but is the most reliable predictor of later suicidal behaviour. This makes efforts to reduce self-injury critical. Emergency departments can be the gateways to care for many people who have self-injured and optimal sites for interventions that promote recovery. However, emergency nurses have anecdotally reported that they lack training and feel ill-equipped to provide care for patients who self-injure. In this open label trial (where both participants and researchers were aware who received the intervention), all nurses in a metropolitan emergency department were invited to complete a multi-modal training programme designed to improve their knowledge, attitudes, confidence, and resilience, and reduce burnout related to caring for patients who self-injure. We also invited nurses to provide feedback in one-on-one interviews. Sixty nurses completed self-report measures at pre, post (immediately following training), and 1-month following training. Gains were seen immediately post-training in knowledge, empathy, self-compassion, and resilience, while reductions were seen in negative attitudes and burnout. In all cases these changes were maintained at 1-month follow-up. Eighteen nurses participated in interviews, who reported on the impact of the training on improving understanding of NSSI and confidence in working with patients who self-injure at both a personal and institutional level. They also identified barriers to implementing training, many of which require system-level changes within the health system. Findings suggest that training integrated within emergency settings can have a significant impact, not only on knowledge and confidence but on the wellbeing of emergency staff working with patients who self-injure.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recognising the Value of Everyday Interactions in Inpatient CAMHS: Patient Thank-You Letters as Insights Into Nursing Impact 认识到住院CAMHS中日常互动的价值:患者感谢信作为护理影响的见解
IF 3.6 2区 医学
International Journal of Mental Health Nursing Pub Date : 2025-05-14 DOI: 10.1111/inm.70062
Sebastian Monteux, Fiona J. Stirling, Marcia Stoll, Lynne Thomas
{"title":"Recognising the Value of Everyday Interactions in Inpatient CAMHS: Patient Thank-You Letters as Insights Into Nursing Impact","authors":"Sebastian Monteux,&nbsp;Fiona J. Stirling,&nbsp;Marcia Stoll,&nbsp;Lynne Thomas","doi":"10.1111/inm.70062","DOIUrl":"https://doi.org/10.1111/inm.70062","url":null,"abstract":"<p>This study explores patient feedback through unsolicited thank-you letters, asking: <i>What insights do these letters provide into impactful nursing practices in inpatient CAMHS?</i> Using an exploratory qualitative approach, data from two focus groups with mental health nurses (MHNs) and an online questionnaire were analysed through thematic analysis, identifying three key themes—‘<i>Being Present</i>,’ ‘<i>Being Skilful</i>,’ and ‘<i>Being Human</i>.’ Findings reveal that thank-you letters offer unique, spontaneous insights into the aspects of nursing care young people value most, highlighting everyday interactions over structured clinical interventions. However, these relational aspects of care are often undervalued in inpatient settings. To ensure they are recognised and sustained, inpatient CAMHS should integrate thank-you letters into staff training, reflective practice, and service development. This study underscores the need to reframe everyday nursing interactions as essential rather than incidental, recognising their critical role in therapeutic engagement and patient well-being.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the Meaning of Collaboration in Rural Mental Healthcare Delivery From the Perspective of Mental Health Clinicians and Informal Carers of People Living With a Mental Health Illness—A Qualitative Study 从精神卫生临床医生和精神疾病患者非正式照护者的角度探讨农村精神卫生服务合作的意义——质性研究
IF 3.6 2区 医学
International Journal of Mental Health Nursing Pub Date : 2025-05-14 DOI: 10.1111/inm.70066
Omolewa ‘Lola Erinle, Michael Olasoji, David Schmidt, Tracy Burrows, Kirsti Haracz
{"title":"Exploring the Meaning of Collaboration in Rural Mental Healthcare Delivery From the Perspective of Mental Health Clinicians and Informal Carers of People Living With a Mental Health Illness—A Qualitative Study","authors":"Omolewa ‘Lola Erinle,&nbsp;Michael Olasoji,&nbsp;David Schmidt,&nbsp;Tracy Burrows,&nbsp;Kirsti Haracz","doi":"10.1111/inm.70066","DOIUrl":"https://doi.org/10.1111/inm.70066","url":null,"abstract":"<p>Mental health policies and practice guidelines emphasise the importance of collaboration with informal carers of people with mental illness, but this does not routinely occur in practice. Understanding the perspective of different parties regarding collaboration is a step towards ensuring an alignment between policy and routine clinical practice. This study explored the meaning of collaboration from the perspectives of informal carers and mental health clinicians in a rural Australian mental health service. This qualitative descriptive study used purposive sampling to recruit informal carers (<i>n</i> = 7) and mental health clinicians (<i>n</i> = 14) from an acute mental health inpatient facility. Data was generated from focus groups and semi-structured interviews and analysed using thematic analysis. Three overarching themes were identified: <i>three-way partnership, purposeful exchange and communication is everything.</i> Clinician and informal carer participants described collaboration as a respectful partnership that necessarily involves the consumer, their carers and clinicians. The purpose of the partnership was identified as providing holistic care <i>to the consumer,</i> which essentially includes support for their carer. Open and clear communication, as well as information sharing, were identified as important to collaboration. However, the experiences of informal carers did not reflect this description of collaboration. Adequate support for informal carers, recognition of their expertise and open and consistent communication are key to a collaborative process that delivers better outcomes for consumers and their carers. Proactive clinician training and a practical guide to inform the delivery of routine informal carer engagement in mental health services are required to achieve an effective three-way collaboration.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Community Treatment Orders in Australia in the Context of International Literature: A Narrative Review of Consumers, Families and Health Professionals' Perspectives 国际文献背景下的澳大利亚社区治疗令:消费者、家庭和卫生专业人员视角的叙事回顾
IF 3.6 2区 医学
International Journal of Mental Health Nursing Pub Date : 2025-05-09 DOI: 10.1111/inm.70061
Madeleine Harvery, Rosamund Harrington, Matthew Morgan, Elisa Yule, Shelley Wright
{"title":"Community Treatment Orders in Australia in the Context of International Literature: A Narrative Review of Consumers, Families and Health Professionals' Perspectives","authors":"Madeleine Harvery,&nbsp;Rosamund Harrington,&nbsp;Matthew Morgan,&nbsp;Elisa Yule,&nbsp;Shelley Wright","doi":"10.1111/inm.70061","DOIUrl":"https://doi.org/10.1111/inm.70061","url":null,"abstract":"<p>A community treatment order (CTO) sets out legal conditions requiring a person experiencing mental illness to receive treatment and medication while living in the community. Although CTOs are used internationally in most high-income nations, CTO use in Australia is very high compared with world standards. CTOs are a contentious issue in mental health practice. While they aim to protect both consumers and society, they often interfere with personal freedom and trust between consumers and mental health professionals. International and Australian research is inconclusive about the effectiveness of CTOs in achieving their clinical aims. Australian research overwhelmingly reports consumers' experience with CTOs as coercive and distressing. Families generally support CTOs but are unhappy with certain aspects of the process. Consumers and families' feelings about CTOs often depend on how much they trust the mental health team, the support they receive, and the relationship between the consumer and mental health professional. Health professionals experience significant challenges balancing therapeutic care with their role carrying out CTOs. Local treatment culture, problems in the mental health system and staff attitudes also influence how CTOs are used. There is a lack of recent and high-quality guidance to inform CTO decision-making for mental health professionals. This perspective paper is presented as a narrative literature review, which proposes that if CTOs are used in clinical practice, close consideration towards how and why they are implemented is warranted.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Insights Into the Australian Stepped Care Model in Primary Mental Health Care: A Qualitative Study With Informal Carers 对澳大利亚初级心理卫生保健阶梯式护理模式的洞察:非正式护理人员的定性研究
IF 3.6 2区 医学
International Journal of Mental Health Nursing Pub Date : 2025-05-09 DOI: 10.1111/inm.70058
Shingai Mareya, Lin Zhao, Mimmie Claudine Watts, Michael Olasoji
{"title":"Insights Into the Australian Stepped Care Model in Primary Mental Health Care: A Qualitative Study With Informal Carers","authors":"Shingai Mareya,&nbsp;Lin Zhao,&nbsp;Mimmie Claudine Watts,&nbsp;Michael Olasoji","doi":"10.1111/inm.70058","DOIUrl":"https://doi.org/10.1111/inm.70058","url":null,"abstract":"<p>Informal carers of people living with mental illness play a significant role in their overall care. This qualitative study investigates informal carers' vital yet often overlooked experiences supporting individuals with mental health conditions within the Australian stepped care model (SCM). Through semistructured interviews with seven carers, the research highlights their perceptions of the SCM's effectiveness and challenges in navigating mental health services. Key themes that emerged include (a) the toll of caring, (b) the hidden door to the SCM, (c) steps towards recovery, (d) carers included in the circle and (e) fine-tuning to elevate the SCM. These findings reveal that while the SCM provides a structured pathway for recovery, many carers encounter significant barriers, a lack of awareness about available services, insufficient support and difficulties accessing the appropriate level of care for their loved ones. The emotional and psychological toll of caregiving is emphasised as carers frequently experience stress, guilt and frustration. Many participants reported feeling overwhelmed by coordinating care and managing crises, adversely impacting their well-being. Moreover, the study underscores the necessity of including carers as active participants in the treatment process. Carers desired better communication with healthcare providers and greater involvement in decision making. Enhancing the visibility of services within the SCM and providing tailored support for carers are critical steps towards improving their overall experience. Addressing these issues can create a more inclusive and effective mental health care system, ultimately benefiting consumers and their caregivers. The findings offer valuable insights for mental health practitioners, policymakers and service providers, emphasising the need for a more integrated approach that recognises and supports the essential role of carers.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of Restrictive Practice Review Meetings in an Acute Mental Health Unit: A Retrospective Before-and-After Study 急性精神卫生部门限制性实践回顾会议的结果:回顾性前后研究
IF 3.6 2区 医学
International Journal of Mental Health Nursing Pub Date : 2025-05-09 DOI: 10.1111/inm.70059
Esario IV Daguman, Alison Taylor, Matthew Flowers, Richard Lakeman, Marie Hutchinson
{"title":"Outcomes of Restrictive Practice Review Meetings in an Acute Mental Health Unit: A Retrospective Before-and-After Study","authors":"Esario IV Daguman,&nbsp;Alison Taylor,&nbsp;Matthew Flowers,&nbsp;Richard Lakeman,&nbsp;Marie Hutchinson","doi":"10.1111/inm.70059","DOIUrl":"https://doi.org/10.1111/inm.70059","url":null,"abstract":"<p>A structured process of reviewing incidents of seclusion and physical restraint supports nurses in managing the emotional and relational impact of restrictive practices. However, these reviews are not a routine feature of everyday acute care provision, and have historically been influenced by practices that reflect a managerial or disciplinary focus. A retrospective before-and-after study was conducted in an adult acute mental health inpatient unit in regional New South Wales, Australia. The goal was to determine the impact of strengths-based restrictive practice review meetings from January 2019 to March 2020, with an equivalent timeframe before its implementation (October 2017–December 2018). The events of seclusion, physical restraint, and Code Blacks (emergency codes requiring security personnel in response to personal safety threats) were compared before and after the implementation of review meetings, with covariate balancing applied to enhance comparability. The reduction in the rate of seclusion was statistically significant post-implementation (incidence rate ratios [IRR] = 0.37, 95% CI [0.24, 0.57], <i>p</i> &lt; 0.001). At the same time, physical restraint showed a statistically insignificant reduction (IRR = 0.76, 95% CI [0.53, 1.09], <i>p</i> = 0.14). Code Black incidents remained stable (IRR = 1.02, 95% CI [0.70, 1.49], <i>p</i> = 0.91). These mixed results indicate that strengths-based reviews play a role in reducing coercion, although additional strategies may be needed to achieve significant reductions in restrictive practice outcomes. Intervention development requires broader service-level changes, with open and robust evaluations that enhance accountability and capture key influencing factors.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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